Sierra Leone is in the grip of one of the worst cholera outbreaks in its history with death rates almost double emergency thresholds and the number of people affected likely to increase significantly in the next month, international agency Oxfam said today.

Almost 12,000 people have contracted the disease across 10 of the country's 13 districts, with 217 deaths recorded as of 20 August, giving a cholera fatality rate of 1.8 percent, beyond the World Health Organisation's (WHO) emergency threshold of 1 percent. The WHO expects that more than 32,000 people are likely to contract cholera during this outbreak.

Oxfam is calling on donor governments and the humanitarian community to increase financial and humanitarian support to the Government of Sierra Leone and its people to assist the supply of clean water and to fund adequate sanitation and hygiene measures, as well as medicine to treat those affected by the escalating crisis. Initial funding requirements were estimated at USD 5 million, half of which have been met by an allocation from the Central Emergency Response Fund (CERF). However, given the severity of the outbreak, this figure will substantially increase.

Grace Ommer, Country Director of Oxfam in Sierra Leone, said "The cholera outbreak is devastating the lives of vulnerable people such as women and child-headed families, disabled and HIV positive people and the elderly. Cholera is a highly preventable and treatable disease, and yet people are dying across the country due to a lack of safe drinking water, inadequate sanitation, and insufficient access to quick and effective medical care. Unless the humanitarian community steps up its response, cholera will continue endanger more lives."

Oxfam is currently reaching 67,000 people in Freetown through emergency water chlorination and is seeking USD 4.2 million to help up to 500,000 people with cholera prevention kits, water purification kits and public information campaigns on how to prevent and seek early treatment of cholera. Oxfam will also be supporting local government efforts to respond to the outbreak.

Cholera is a highly-contagious disease that spreads rapidly through areas of poor sanitation, dirty water and overcrowding. The annual raining season in Sierra Leone, from May to October is usually a time when the risk of cholera increases. However, this year cholera started much early than expected, with the first cases being confirmed in January 2012. Ten years after civil war finished, Sierra Leone is still rebuilding and requires substantial investment in water and sanitation. Only 57 percent of Sierra Leoneans have access to safe drinking water, and only 40
percent have access to a private or shared latrine, leaving the majority of the people vulnerable to water-borne diseases. Sewerage systems are also extremely limited.

"The immediate priority is to ensure that people are able to prevent themselves and their families from contracting cholera, or get rapid treatment when they are affected. However, the country needs to tackle this cyclical nature of cholera. Massive investment in sanitation and water is needed to ensure an outbreak of this magnitude never happens again," said Ommer.

Sierra Leone is a country the size of Wales and has a population of approximately 6 million people. The 10 districts currently affected by the outbreak are: Western Area, Port Loko, Kambia, Pujehun, Bo, Bombali, Moyamba, Tonkolili, Kono and Bonthe.

Oxfam's emergency response is currently operational in 9 city sections of Freetown, providing water chlorination to 67,000 people. It has also trained 90 "Blue Flag Volunteers", the Government of Sierra Leone's official volunteer community health initiative, and run 63 radio programmes to provide health and hygiene messaging to communities. Oxfam has constructed four emergency latrines and a 10m3 water bladder to improve water and sanitation facilities at Lumley hospital, in western Freetown.

Oxfam has been working in Sierra Leone since 1998. Since its humanitarian water, sanitation and hygiene response during the civil war, Oxfam has continued to work in three districts to provide longer-term water and sanitation to communities, improve the rights of women to own land and property and increase women participation in Government.